EFECTOS DE LA INTERVENCIÓN EN ALFABETIZACIÓN EN SALUD PARA MEJORAR LA SINTOMATOLOGÍA DEPRESIVA Y DE ANSIEDAD. REVISIÓN SISTEMÁTICA Y META-ANÁLISIS

1. Introducción: La alfabetización en salud supone un factor directamente condicionante en la relación de los pacientes con el sistema de sanidad y con su propia salud. A pesar de ello, las labores en promoción y formación en AS no son suficientes, pues siguen existiendo muchas disparidades en la AS de la población, incluso en aquella con un nivel de alfabetización general alto. La AS también está intrínsecamente relacionada con la posibilidad de tomar decisiones de forma independiente e informada sobre la salud de los individuos. Por otro lado, los trastornos afectivos (depresión y ansiedad) siguen aumentando en prevalencia en la mayoría de los grupos poblacionales.2. Objetivo: Analizar la evidencia científica disponible sobre la alfabetización en salud y su relación con conductas asociadas a pacientes con depresión y ansiedad (revisión sistemática y metaanálisis)3. Metodología: Revisión sistemática y metaanálisis en las diferentes bases de datos, escogiendo ECAs que valorasen con escalas validadas tanto la AS como la depresión y/o la ansiedad. 4. Resultados: Del análisis estadístico del metaanálisis de los estudios y sus intervenciones obtenemos que las variables fueron significativas; la AS un valor de -0.015 (IC 95%: -0.076, 0.047), la depresión en adultos fue -1.507 (IC 95%: -2.064, -0.950), la ansiedad en adultos -0.961 (IC 95%: -2.280, 0.359). La heterogeneidad de ansiedad y depresión fue estudiada, obteniendo la conclusión de que las edades de los sujetos suponen una variable moderadora significativa. 5. Limitaciones: A pesar de que en una primera revisión aparezcan muchos estudios, una vez cribados, se pierden muchos por no incluir ni las escalas validadas ni tener los valores previos y posteriores a la intervención, necesarios para el metaanálisis. 6. Conclusiones: A pesar de sacar resultados positivos, relacionados con la relevación del conocimiento de la enfermedad y la AS en general y su impacto conductas asociadas a pacientes con depresión y ansiedad, se siguen necesitando más estudios y desarrollo de programas de intervenciones para seguir evaluando la AS de la población general y como aumentarla de la manera más efectiva, con el fin último de empoderar, informar y acompañar al paciente siempre de la mejor manera posible. 7. Palabras clave: alfabetización en salud, depresión, ansiedad, alfabetización en salud mental, ensayo clínico aleatorizado, escalas AS, escala depresión, escala ansiedad. <br /

Relationship between initial symptoms and the prognosis, sex, and demographic area of patients with COVID-19

BackgroundA method of determining the initial symptoms and main prognostic identifiers for COVID-19 can be a key tool for physicians, especially primary care physicians. Therefore, the objective of this study was to examine the prognosis of patients with COVID-19 from two different demographic regions according to baseline and main symptoms, age, and sex.MethodsAll individuals selected from both urban and rural health centers were over 18 years of age, had COVID-19 before 2 March 2021, and were followed up with a primary care physician. All patients included in this study were recruited in terms of sex, age at the time of infection, type of contact, baseline symptoms, primary and secondary symptomatology, emergency assistance, hospitalization, intensive care unit (ICU) admission, and death.ResultsA total of 219 and 214 subjects were recruited from rural and urban health centers, respectively. Subjects with COVID-19 from rural areas were significantly older in age, with a higher proportion of men, and had significantly lower baseline and main symptoms than those from urban areas. In addition, the presence of both fever and dyspnea as the initial or main symptom is significantly associated with emergency assistance, hospitalization, and death, regardless of sex, age, and demographic area. This type of illness was reported to be significantly less frequent in the rural population than in the urban population.ConclusionThe presence of both fever and dyspnea as both initial and main symptoms is a poor prognostic factor for COVID-19, regardless of age, sex, and demographic areas. In addition, women reported lower levels of fever and dyspnea, requiring minimal emergency assistance and fewer hospitalization, and a lower rate of mortality than men. During a COVID-19 infection follow-up, subjects in rural areas seem to have less access to medical care than those in urban areas

Relationship between initial symptoms and the prognosis, sex, and demographic area of patients with COVID-19

A method of determining the initial symptoms and main prognostic identifiers for COVID-19 can be a key tool for physicians, especially primary care physicians. Therefore, the objective of this study was to examine the prognosis of patients with COVID-19 from two different demographic regions according to baseline and main symptoms, age, and sex.MethodsAll individuals selected from both urban and rural health centers were over 18 years of age, had COVID-19 before 2 March 2021, and were followed up with a primary care physician. All patients included in this study were recruited in terms of sex, age at the time of infection, type of contact, baseline symptoms, primary and secondary symptomatology, emergency assistance, hospitalization, intensive care unit (ICU) admission, and death.ResultsA total of 219 and 214 subjects were recruited from rural and urban health centers, respectively. Subjects with COVID-19 from rural areas were significantly older in age, with a higher proportion of men, and had significantly lower baseline and main symptoms than those from urban areas. In addition, the presence of both fever and dyspnea as the initial or main symptom is significantly associated with emergency assistance, hospitalization, and death, regardless of sex, age, and demographic area. This type of illness was reported to be significantly less frequent in the rural population than in the urban population.ConclusionThe presence of both fever and dyspnea as both initial and main symptoms is a poor prognostic factor for COVID-19, regardless of age, sex, and demographic areas. In addition, women reported lower levels of fever and dyspnea, requiring minimal emergency assistance and fewer hospitalization, and a lower rate of mortality than men. During a COVID-19 infection follow-up, subjects in rural areas seem to have less access to medical care than those in urban areas

European general practitioners’/family physicians’ attitudes towards person-centered care and factors that influence its implementation in everyday practice : preliminary results

Background: Person-centered care (PCC) is widely acknowledged as a core value in family medicine and has been associated with many positive outcomes of care. There has been no comparison of GPs attitudes towards person-centeredness across European countries. Research questions: To investigate GPs/FPs attitudes towards person-centeredness. To understand GPs/FPs facilitators and barriers related to practicing PCC. To document obstacles to practicing PCC in practice. Method: A cross-sectional questionnaire-based study across 22 European countries (finished in one country, in 10 countries ongoing, in 11 countries finishing the preparatory phase). In each country, the population of GPs/FPs will be reached through the official mailing list of the national medical associations. The study instrument consists of four parts: General information about the doctor and the doctor's office, Perceived Stress Scale (PSS), Patient Practitioner Orientation Scale (PPOS) and Facilitators and barriers to PCC in everyday practice. The Ethics Committee, School of Medicine, University of Zagreb approved the project. The study will be carried out in close collaboration with the European Association for Quality and Patient Safety in Primary Care (EQuiP) and the European General Practice Research Network (EGPRN). The study will be coordinated by the Department of Family Medicine, School of Medicine University of Zagreb (Croatia). The project is supported by the EGPRN Grant. Results: GPs/FPs attitudes towards person-centeredness will be described and investigated in correlation to sociodemographic data and work stress in each participating European country. GPs/FPs facilitators and barriers to practicing PCC in everyday practice will be analysed. Data will be analysed using software package STATISTICA 7.1 (StatSoft Inc, Tulsa, OK, USA), and P < .05 will be considered statistically significant. Conclusions: Regardless of the specific context of care that is highly dependent on the patient, physician and healthcare system characteristics, PCC represents a core value of family medicine that should be implemented in GPs/FPs everyday work across Europe